Outcomes of Endovascular and Open Treatment for Chronic Mesenteric Ischemia

Abstract

The number of patients treated for CMI continues to increase and correlates with the increasing utilization of endovascular procedures. The patients undergoing endovascular treatment had fewer complications, lower in-hospital mortality, and a greater likelihood of being discharged home.

Differences in anatomy and outcomes in patients treated with open mesenteric revascularization before and after the endovascular era

“…Nevertheless, these results are not easily reproduced in the vascular community, as evidenced by a recent analysis of the New York State Health Department database showing a mortality rate of 20% following open revascularization for chronic mesenteric ischemia. 12 These discrepancies likely reflect differences in outcomes between large and low-volume centers and the impact of a multidisciplinary team to select the optimal treatment modality for each patient, whether open, endovascular, or a hybrid approach.…”

Chronic mesenteric ischaemia: 28-year experience of endovascular treatment

“…Therefore, there has been a clear trend towards endovascular treatment rather than open surgery being the first line of therapy for revascularisation for CMI [24,25]. In this series, 62% of the patients were discharged within 24 h of the procedure (mean 0 3.4 days) and 90.4% were ultimately discharged from the hospital to home compared with only 37% from a New York database after open surgery [26].…”

Radiology and mesenteric ischaemia

“…This is due to the decreased peri-operative morbidity and mortality associated with the percutaneous approach. 71,72 Significant debate exists about the most appropriate approach for endovascular treatment in CMI. The number of vessels to treat and covered versus bare metal stents are two of the areas where there has been research focus in the last 5 years.…”